Hip Pathologies

Question 1

Hip pathology most commonyl presents with pain where?

Answer 1

Groin

Question 2

In which three locations can hip pain present?

Answer 2

1. Groin
2. Knee
3. Buttocks

Question 3

Why can hip pain be felt in the knee?

Answer 3

The obturator nerve innervates both areas

Question 4

In which condition can hip pain characteristically present only with knee pain in some instances?

Answer 4

SUFE

Question 5

In clinical examination what is generally the firstsign of hip pathology?

Answer 5

Loff of internal rotation

Question 6

Which type of total hip replacement is the gold standard?

Answer 6

Cemented metal/polyethylene

Question 7

What is loosening of a hip replacement due to?

Answer 7

1. Wear particles on the articualr surface form
2. Macrophages detect such particles as foreign and release inflammatory mediators
3. Osteoclasts become activated at the implant/bone barrier causing loosening over time

Question 8

What are possible early local complications of total hip replacement?

Answer 8

1. Infection
2. Dislocation
3. Nerve injury
4. Leg length discrepancy

Question 9

What are the possible early general complications of total hip replacement?

Answer 9

1. MI
2. Chest infection
3. UTI
4. Blood loss
5. Hypovolaemia
6. DVT and PE

Question 10

What are the possible late local complications of total hip replacement?

Answer 10

1. Early loosening
2. Late infection
3. Late dislocation

Question 11

Where is pain generally felt for AVN in the femoral head?

Answer 11

Groin

Question 12

Later cases of AVN show changes on X-ray, what are these changes (before collapse)?

Answer 12

1. Patchy sclerosis of the weight bearing area
2. Lytic zone underneath patchy sclerosis (formed from granulation tissue) which causes the classical sagging rope sign (also seen in Perthes)

Question 13

If AVN of the femoral head is caught early enough, what is the treatment?

Answer 13

Drill holes can be made up the femoral neck into the diseased region to decompress, promote healing and prevent collapse

Question 14

When AVN of the femoral head collapses, what is the treatment?

Answer 14

Total hip replacement